HI Dr,i have been taking Truvada and Efavirenz for 3years but suffered a lot of bad dreams.My Dr recommended Etravarine as a replacement for Efavirence, I took Etraverine for 2months and i have gone completely depressed.Rilpiverine has been recommeded.Is this the right move for me since i have read that Rilpivirine is for patients who are starting HIV medication for the first time.

Response from Dr. McGowan

HI,

As long as you have never had detectable viral load with drug resistance while on treatment, switching for toleravbility issues is generally safe. These 3 meds are all in the same family (non-nucleoside analog reverse transcripatase inhibitors, or NNRTIs for short). Usualy if efavirenz (the NNRTI in Atripla) works, the other 2 (etravirine and ripilvirine) should also work. Rilpivirine is generally well yolerated, can be once a day (in a single pill called Complera..similar to Atripla), but it must be taken with a full meal (400+ calories) and avoid with antacids. So, it may be an option. Be sure your viral load has remained undetectable with the switches made before changing again.

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